Giles
Our HoYAG manual does not state it has an RF/ EMF interference problem.
Devices are CE labelled wrt the EMF regs
I am only aware of some ophthalmic refractive lasers which have an EMf
issue
The defib would be looking for changes in cardiac electrical signal. Any
change may make its algorithm make decisions, eg defib or not. Induced
currents in the patient can create false information. Surgical diathermy
clearly interferes with ICDs due to saturation of front end
amplification, although at high frequency ( eg 400Hz) there is 50Hz
modulation within the diathermy current.
ICDs and other implantable pulse generators are programmed via a RF
signal. Devices can change mode if very high RF fields are used, eg the
device thinks it is under attack, and may revert to a safe mode. This
would require a custom clinical programmer to restore parameters.
The patient will be managed by the anaesthetist during the procedure.
You could have the patient monitored by someone from cardiology during
the procedure. We do this for patients with cardiac pacemakers who are
having an addition neurostimulator fitted/ tested, ie to ensure the
extra stimulation of the second IPG system does not create false
positive signals when the pacemaker should operate.
The surgeon will need to have surgical diathermy available to control
unwanted bleeding that may occur, so you may be forced with undertaking
the latter monitoring option anyway
Matt
Matt Williamson
Laser Protection
Medical Physics & Engineering
Leeds Teaching Hospitals NHS Trust
Leeds General Infirmary
Tel 01924 212900
mob 07768 987956
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-----Original Message-----
From: British Medical Laser Association [mailto:[log in to unmask]] On
Behalf Of Giles Morrison
Sent: 11 January 2008 10:30
To: [log in to unmask]
Subject: Ho:YAG and defibrillators
Dear All
Is anyone aware of any complications in using a Ho:YAG to treat a
bladder tumour in a patient with an implanted defibrillator? Such
defibrillators are sensitive to diathermy use. Is there likely to be
sufficient EMF from a Ho:YAG to affect the defibrillator?
We have such a patient requiring treatment and I would welcome any
advice.
Giles
Giles D. Morrison
B.Sc. M.Sc. MBA C. Phys MInstP MIPEM AKC
Radiation Protection Adviser
Head of Radiation Protection Services
Sheffield Teaching Hospitals NHS Foundation Trust
NHS Innovations Competition Yorkshire and Humber 2007 finalist
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